1. HIT Policy Committee PCAST Report Workgroup Wednesday, February 2, 2011 Paul Egerman, Chair William Stead, Vice Chair

2. Workgroup Members Members: Dixie BakerSAIC Hunt BlairVermont HIE Tim ElwellMisys Open Source Carl A. GunterUniversity of Illinois John HalamkaBeth Israel Deaconess Medical Center, HMS Leslie HarrisCenter for Democracy & Technology Stan HuffIntermountain Robert Kahn Corporation for National Research Initiatives Gary MarchioniniUniversity of North Carolina Stephen OndraOffice of Science & Technology Policy Jonathan PerlinHospital Corporation of America Richard PlattHarvard Medical School Wes RishelGartner Mark A RothsteinUniversity of Louisville School of Medicine Steve StackAmerican Medical Association Eileen TwiggsPlanned Parenthood Chair: Paul Egerman, Chair Vice-Chair: William Stead, Vanderbilt University 2

3. ONC Request for Comment Overview On Dec 8, 2010, the President’s Council of Advisors on Science and Technology released their Report entitled "Realizing the Full Potential of Health Information Technology to Improve Healthcare for Americans: The Path Forward." On the same day, ONC published a Request for Comment asking the public 9 questions regarding: –The impact of PCAST on ONC activities –Initial thoughts on PCAST recommendations –How they want ONC to act on the PCAST recommendations Public comment was due on Jan 19 th, 107 comments were received 3

4. Workgroup Charge The PCAST Report Workgroup is charged to : Assist ONC synthesize and analyze the public comments and input to the PCAST report; Discuss the implications of the report and it’s specific recommendations to ONC on current ONC strategies; Assess the feasibility and impact of the PCAST report on ONC programs; Elaborate on how these recommendations could be integrated into the ONC strategic framework. 4

5. Meeting Dates January 7, 4:30 to 5:30 pm/ET Jan 14, 2 to 4 pm/ET Jan 27, 11 to 2 pm/ET Feb 10, 12 to 2 pm/ET Feb 15 -16, In-person Stakeholders Hearing, Washington DC Mar 3, 1 to 4 pm/ET Mar 17, 10 to 1 pm/ET April 13, Present Final Report to HIT Policy Committee April 20, Present Final Report to HIT Standards Committee Meeting Dates 5

6. PCAST Report: Three Major Directions 1. Accelerate progress toward a robust exchange of health information. 2. Establish an exchange architecture with a universal exchange language, supporting infrastructure, and strong privacy and security safeguards. The exchange architecture will enable physicians and patients to assemble a patient's data across organizational boundaries, consistent with persistent patient privacy preferences. 3. Establish an evolutionary transition that builds upon existing EHR installations and ONC's Clinical Document Architecture (CDA). 6

7. Exchange Architecture Concepts a)Use of an extensible language, with XML as an example. b)A more atomic approach to exchange, using tagged data elements. c)Record Locator / Data Element Access Service (DEAS) functionality d)Persistent privacy safeguards that travel with the data e)Use of PHR in exchange f)Decouple syntax and semantics, the latter becoming plug-ins g)Decouple security key management, data, indexing and aggregation 7

8. Call to Order Tuesday, February 15, 8:30am – 5:15pm 8:30 a.m. Call to Order/Roll Call 8:35 a.m. Meeting Objectives and Outcomes – Workgroup Chairs 8:50 a.m. Panel 1: Overview of PCAST Report / Framing Questions 9:30 a.m. Panel 2: Patients / Consumer / Privacy Advocates 10:45 a.m. Panel 3: Providers and Hospitals 12:15 p.m. LUNCH BREAK 1:00 p.m. Panel 4: Health Information Exchange and Healthcare Stakeholders 2:15 p.m. Panel 5: Population Health 3:30 p.m. Panel 6: Technical Panel 4:45 p.m. Discussion: Summary Comments 5:00 p.m. Public Comments 5:15 p.m. Adjourn Stakeholder Hearing – Tuesday Agenda 8

9. Call to Order Wednesday, February 16, 9am – 12:30pm 9:00 a.m. Call to Order/Roll Call 9:05 a.m. Meeting Objectives and Outcomes, Review/Summary of Tuesday’s Hearing – Workgroup Chairs 9:30 a.m. PCAST Workgroup Deliberations 12:00 p.m. Summary Comments from the Workgroup 12:15 p.m. Public Comments 12:30 p.m. Adjourn Stakeholder Hearing - Wednesday Agenda 9